Idiopathic thrombocytopenic purpura(ITP)-like syndrome is a very rare paraneoplastic syndrome which is caused by autoimmune mediated platelet destruction. Thrombocytopenia in malignant tumor is usually known to be caused by several mechanisms including marrow replacement with tumor, marrow hypoplasia secondary to chemotherapy, platelet consumption due to activation of the coagulation cascade and the mechanism of autoimmune mediated platelet destruction has been also described. While most cases are documented in lymphopro- liferative disorders, it is extremely rare in solid tumor. We experienced a case of thrombocytopenia which could not be explained by usual mechanisms in a patient with gastric adenocarcinoma. In the case, ITP-like syndrome was suspected because no evidence of DIC was faund and all trials of platelet replacement were failed because of refractory response. As expected, the patient showed positive response to anti-platelet antibody, and spontaneous remission was achieved by administration of high dose immunoglobulin and prednisone with chemotherapy simultaneausly. We did not splenectomy, because platelet number was maintained well with above therapy. We report a case of ITP-like syndrome in gastric adenocarcinoma patient and so far as can be determined there has not been reported.
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